EFFECTIVENESS OF SHORT MESSAGING SERVICE OF CRITICALLY APPRAISED TOPIC CONCLUSIONS AS A CONTINUING MEDICAL EDUCATION STRATEGY

Purpose:     Background. Doctors especially in third world countries find it arduous to keep abreast medical advances despite different strategies (continuing medical education; internet; evidence based medicine) with over six million articles published annually.  Short Messaging Service (SMS) or text message is a quick, cheap, and highly accessible means to deliver information through mobile telephones.  SMS may be effective in bridging the widening gap between research and action.     Objectives.  1) To determine if SMS is effective in increasing knowledge and changing prescription practices of physicians.  2) To determine physicians’ perceived usefulness of information relayed by SMS.

Method:      A before and after study was conducted among the 60 residents-in-training of the Department of Medicine, Philippine General Hospital.  Authors performed a systematic search on the use of diuretics for hypertension and found the ALLHAT trial which they critically appraised. 

Conclusions favoring diuretics were sent via SMS to all residents twice, 10 weeks apart.  Prescription-recording for 2-week duration was done before, 2 weeks after and 4 weeks after the first SMS, and 2 weeks after the second message.  Pre- and post-tests were administered to assess knowledge gain.  Perceived usefulness and acceptability were determined through questionnaires at the end of the study.  Number of residents who requested access to the full article was recorded.

Result:    1) There were increases in diuretic prescription from baseline of 22.9% (n=69/301) after the SMS was sent -- immediately to 28.1% (n=56/199); sustained at 24% (47/196); and boosted after the second text message to 30.1% (n=44/146).  None of the comparisons were   statistically significant.     2) There was an increase in knowledge scores for 3 out of 4 questions, of which 2 were statistically significant.  There was a statistically significant decrease in 1 question.     3) Most respondents (92.2%; n=47/51) perceived the text message useful, and 45.1% (n=23/51) claimed that receiving it changed their prescription practice.  Almost half (49%; n=25/51) felt the need to read the article’s appraisal after receiving the SMS.  All respondents would like to receive texts of CAT conclusions.  Conclusion:    SMS can be effective in improving physicians’ knowledge.  Majority deemed it useful.  All desired to receive informative texts in the future.  SMS seems to effect change in practice among physicians, however this should be further tested in larger trials to reach statistical significance.